Comparing the use of Arabic decision aid to usual care. A multicenter randomized controlled trial for Arabic speaking metastatic colorectal cancer patients in Saudi Arabia

Abstract

Objectives: To evaluate the effect of decision aids (DAs) for metastatic colorectal cancer (mCRC) patients in the Arabic language.

Methods: A multi-centered randomized control trial was used to evaluate the effect of Arabic DA use with usual care for mCRC patients compared to usual care alone. Patients were recruited from 4 main oncology centers in Saudi Arabia: King Fahad Medical City, Riyadh; King Khalid University Hospital, Riyadh; King Saud Medical City, Riyadh; and King Fahd Specialist Hospital, Dammam, Saudi Arabia, between March 2016 and October 2018. The final follow up was in April 2019. The study measured patient understanding of prognosis, treatment options, and the level of the patient's anxiety.

Results: Ninety-two patients were included in the analysis; 51 in the intervention group. A small proportion of both (DA with usual care and usual care) understood that mCRC was incurable (8% and 5%) of the 2 groups, respectively. There was no significant difference between groups in anxiety level; however, a time effect both initially and after one month was significantly higher than at 6 month.

Conclusion: The study shows that a higher level of patient's baseline understanding lowered anxiety levels over time. Decision aids group presented low levels of anxiety over time than those provided the usual care. We recommend using Arabic DA in the oncology centers dealing with mCRC patients, aiming to empower patients in decision making.

Figure 1

Randomization and patient’s status at the end of the study.

Figure 2

Patient’s understanding scale domains by randomization group.

Figure 3

Anxiety severity scores by A) randomization group and B) understanding scale (low versus high) over study period